Provider Demographics
NPI:1972508893
Name:PIH HEALTH WHITTIER HOSPITAL
Entity Type:Organization
Organization Name:PIH HEALTH WHITTIER HOSPITAL
Other - Org Name:PIH HEALTH HOSPITAL WHITTIER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SPECIAL PROJECTS
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:R
Authorized Official - Last Name:PONCE (AKA CARLSON)
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-698-0811
Mailing Address - Street 1:12401 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-1006
Mailing Address - Country:US
Mailing Address - Phone:562-698-0811
Mailing Address - Fax:562-698-6238
Practice Address - Street 1:12401 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1006
Practice Address - Country:US
Practice Address - Phone:562-698-0811
Practice Address - Fax:562-698-6238
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIH HEALTH HOSPITAL WHITTIER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA930000129273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05T169Medicare Oscar/Certification